Social causes of prescription drug addiction

Background

Since the 1990’s, policy makers and researchers have noticed an increasing trend in the use and abuse of prescription drugs in the U.S. In fact, administrations from across the Health and Human Services network have teamed up to better address the prescription drug addiction problem and to make Americans more aware of the issue. Just to name a few, the Food and Drug Administration (FDA), the Drug Enforcement Agency (DEA), the Substance Abuse and Mental Health Services Administration (SAMHSA), and the National Institute on Drug Abuse (NIDA) all have something to say about prescription drug use.

But what is causing prescription drug addiction? And what systems require an overhaul? First, we need to understand the markets for prescription drugs; mainly people are taking sedatives, stimulants and pain killers. Then, we can examine who is at risk of prescription drug misuse and why. Finally, we will address what can be changed .

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The market

More than 70% of all prescription drugs that are misused are being prescribed by doctors. According to the Addiction Technology Transfer Center’s (ATTC) Connect to Fight RX Abuse initiative, the legitimate commercial production and sale of pharmaceutical drugs increased markedly in the 1990’s. At about the same time, the pharmaceuticals began to increase marketing campaigns to doctors about pain medications. And, no surprise, doctors started writing more campaigns for pain meds. To quote the Connect to Fight RX Abuse website, “Prescriptions written for controlled drugs increased more than 150 percent from 1992 to 2002 – almost 12 times the rate of increase in the population and almost three times the rate of increase in prescriptions written for all other drugs.” Now, that must have been SOME marketing campaign.

At the same time that adults were being prescribed pain medications, ADHD hit the market as a trendy diagnosis and kids all around the country starting taking (and distributing) Ritalin. Used appropriately, Ritalin can help improve the lives of children and teens by helping them keep and maintain focus and attention. However, as people increasing began to know that these medications existed, demand for pills soared. Doctors responded accordingly. Medicines have been over prescribed since, and access to prescription drugs has been easier than ever with online pharmacies adding convenience into the bargain.

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The environment

Although young adults aged 18-25 normally register the highest rates of non medical use of prescription drugs, adolescents and the elderly are particularly at risk for becoming dependent upon pharmaceuticals. Just think about the kinds of drugs that are available now in school environments, or in the medicine cabinets of families in the U.S. Anti-anxiety, anti-pain, anti-depressants … just about any shade of drug can be supplied out of the home or school. This type of inappropriate access simply fuels trends for people to give one another medicines.

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The suggestions

Simply, I suggest that everyone become more responsible. The health care system must make information about prescription drug addiction available and campaign for reasonable use of drugs. Health care providers must discuss the potential for addiction during initial visits for medications, rather than as an after-sight. Doctors need to update their skills and know how to screen, assess and refer people for prescription drug use; they need to know what kinds of questions to ask and the learn the right language it takes to discover addiction problems. Doctors also need to TAKE TIME to be with patients. Fast paced medical visits need to stop, as does the practice of prescribing unnecessary meds.

Pharmacists need to educate and counsel patients about HOW and WHEN to take medications….and stop trying to get people to sign away their right to be counseled. Pharmacists also need to be aware (as doctors do) that medical histories also include previous addictions or current use of alcohol or cigarettes. When pharmacists concentrate only other medications or supplements, etc. they can overlook potential interactions that can be extremely serious for users of prescription drugs.

Finally, we as consumers need to take stock. We need to be aware of drug supplies in the home and keep drugs under wrap. Parents need to talk to kids about misuse of medications and their consequences. We need to watch out for our elderly parents and grandparents, who can have a tendency to forget or confuse medications. We need to connect with our seniors to prevent the isolation than can drive them to take medications more frequently than they should, or to mix meds with alcohol. We also need to know how to identify prescription drug misuse and know what steps to take next.

In sum, the prescription drug epidemic is truly systemic. Unless we each take personal responsibility to curb its growth, it will continue to grow. But enough from me. What do you think? Your thoughts, ideas, comments, and feedback will be posted here.

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8 Responses to “Social causes of prescription drug addiction”

Jana Burson M.D.

8:25 pm August 18th, 2010

Excellent blog…… Prescription opioid addiction has increased dramatically over the last decade, due to a combination of factors. First, there was the pain management movement, which emphasized the importance of adequate pain control. Of course that’s an admirable goal, but the risks of addiction were understated due to bad science and misinterpretation of limited data. Instead of a risk of addiction of about 1%, quoted by many pain management gurus, the true incidence is more like 10 – 45%, depending on which study you read.

Then against that backdrop, OxyContin was released and marketed to general practitioners and family docs with limited knowledge about how to identify and treat addiction. In general, medical schools and residencies have done a lousy job of educating doctors about proper prescribing of opioid medications, how to identify addiction, and where to refer people for treatment of their addiction. Then there was access to opioids via the internet, which actually seemed to be a bigger problem than it was. A small percentage of abused opioids came from the internet, but some people became addicted in that way. With the changing laws, these rogue internet pharmacies are less numerous.

Jana Burson M.D.

8:27 pm August 18th, 2010

States most heavily afflicted by pain pill addiction didn’t have prescription monitoring programs in place. These programs are essential tools to identify people who are getting pills from more than one doctor at a time, called “doctor shopping,” which is often an indication the person has an addiction that needs treatment. Fortunately, most states either have these programs now or are in the process of putting them into place.

Jana Burson M.D.

8:28 pm August 18th, 2010

But a big part of the problem is cultural. We share prescription medications, even controlled substances, with alarming frequency. Most people aged 18 – 24 who use pain pills nonmedically get them from friends or family, not from some nefarious dealer on the corner. Adolescents don’t realize how dangerous prescription pain pills are.

Anyone with pain pills in their medicine cabinet needs to lock them up to keep them safe, or dispose of medication when they are no longer needed. And we need to stop sharing our medications!!!

Cary

3:55 pm August 19th, 2010

Your article was really good. I truly feel what is causing Prescription Drug Addiction is the “Illegitimate Pain Management Doctors”. Specifically, there are many doctors who know full and well that they are prescribing drugs to either a drug addict or knowing they are prescribing a drug way to powerful for that person’s condition. So, why do they do this? Unfortunately they do this to get a person hooked so that person has to come back to their office each and every month to fill their prescription. They make enormous amounts money doing this. I feel there should be much stricter guidelines with the FDA and DEA with regard to doctor’s procedures. The doctors need to know they are being checked regularly. Quite frankly, every single record should be checked, even now from years ago, to see if in fact the person had to either do a urine test, had x-rays taken, or had an MRI taken. I am sure if this was done today, they would find no records at all, only to learn the person diagnosis was “my back is killing me”. When you think a Pain Management doctor charges an average of $200.00 a month for the visit, (which they don’t normally even see the person), times that by thousands of clients, it’s like a legalized drug dealer. To conclude, I think the DEA and the FDA should really start doing some undercover work to see what really goes on in these doctors offices.

Veritas Villa

2:11 am September 2nd, 2010

Dr. Burson is completely right. There are a number of reasons for the increase in prescription drug addiction. Everyone should take responsibility, and be aware of this issue. It is all too common for people to share their medication. A patient has their wisdom teeth removed, and is prescribed hydrocodone for the pain. They end up with a few left over, so when their friend has a headache, they think nothing of sharing. A parent with a sleep disorder notices that their child is having a hard time falling asleep the night before a test, so they give them one of their prescription sleep aids. Pharmacy resources are taxed, and people are anxious to get their medications. Our pharmacies are often more like fast food counters than they are medical facilities. It is frightening to think about.

Alcoholic Definition

11:31 pm September 6th, 2010

The ladies in my group spent an hour talking on this subject last night. I’ve even gotten two emails about it today. It’s a hot topic.

RYAN DONNELLY

9:50 am September 16th, 2010

Hello, I have a blog that tells my story of my battle with addiction. I am impressed with your site. Thank You,

Ryan Donnelly

Alcoholism

9:57 pm October 24th, 2010

We just discussed this last night in group. Everytime someone relapses, which is all to frequently, we have to go over what happened and devise tactics to defeat it next time. Sometimes that means re-visiting the basics and sometimes it gets a lot more complicated. Anyway, thanks for sharing.

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